title: Ergonomic assessment of enhanced protection under body armour combat shirt neck collars.
abstract: BACKGROUND
  Combat neck injury due to explosively propelled fragments is a significant cause of mortality and long-term morbidity in UK soldiers deployed on current operations. Reinforcing the collar of the existing under body armour combat shirt (UBACS) has been suggested as a potential method for reducing the incidence of combat neck injury.
  
  
  METHODS
  20 soldiers serving in Afghanistan objectively compared three designs of enhanced protection UBACS (EP-UBACS) using 10 representative military tasks against a baseline of a standard UBACS. Each EP-UBACS design was trialled using three constituent materials: two layers of para-aramid felt, one layer of ultra high molecule weight polyethylene (UHMWPE) felt or two layers of a silk fabric. Subjective assessment of these nine configurations in terms of comfort, heat dissipation and overall acceptability were compared with the standard UBACS using a χ² test.
  
  
  RESULTS
  All military tasks could be performed with all nine configurations of EP-UBACS. Although silk was the most comfortable material, it was not functionally practical in any of the three designs. Crossover collars incorporating UHMWPE or para-aramid were the only two of the nine configurations to demonstrate similar user acceptability to a standard UBACS.
  
  
  CONCLUSIONS
  The EP-UBACS has the potential to provide neck protection without reducing performance incorporating materials analogous to either of the felts assessed in this study. The collar should provide stand-off from the skin to improve heat dissipation and comfort, which can be maximised by changing the current UBACS collar shape to one that crosses over at the front. Should a zip be desired, it should be moved to one side of the midline to reduce rubbing on the chin and be covered with ballistic protective material. Additional semi-circles of silk beneath the collar at the front and back would improve protection without affecting comfort.
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham Research Park, Birmingham, UK.
authors.forename: John
authors.initials: J
authors.lastname: Breeze
authors.forename: C J
authors.initials: CJ
authors.lastname: Granger
authors.forename: T D
authors.initials: TD
authors.lastname: Pearkes
authors.forename: J C
authors.initials: JC
authors.lastname: Clasper
mesh_terms: D000346:Afghanistan; D004867:Equipment Design; D006804:Ergonomics; D006801:Humans; D008422:Materials Testing; D008889:Military Personnel; D019838:Neck Injuries / Q000517:prevention & control*; D011481:Protective Clothing; D013647:Task Performance and Analysis; D014857:Warfare
keywords: Health Economics; Occupational & Industrial Medicine